The Virginia Institute for Surgical Arts Blog

Rhinoplasty can be broadly classified into open and closed rhinoplasty, which are the two main operative techniques to correct the cosmetic and functional properties of the nose. Many nose surgeons prefer to perform closed rhinoplasty because the procedure is relatively less invasive. Patients often want this option because it leaves no visible scars on the outside.

In case of closed rhinoplasty, surgical access to the nose is achieved through incisions placed inside the nose. This endonasal approach to perform nose surgery has traditionally been more popular, while open rhinoplasty has only gained more popularity in recent years.

Closed Technique

In case of closed rhinoplasty technique, the cosmetic and functional improvements to the nose are made internally through the nostrils. This avoids the need for an incision at the bottom of the nose. The technique may be more appropriate for patients who require limited correction or the ones who are receiving cosmetic nose surgery for the first time.

Changes with closed rhinoplasty technique are usually more subtle and uncomplicated. Results are scarless and more natural looking. Recovery is faster and involves reduced risk of complications as compared to open rhinoplasty. The nose surgeon should have training and experience to perform closed rhinoplasty with precision because the underlying nasal structures will not be openly visible.

Candidacy

Candidates for closed rhinoplasty typically have less severe nasal deformities, tip symmetry, a midline bridge, and no history of significant nasal trauma. Complicated or asymmetric noses are not ideal for this type of nose surgery. Patients may not only seek closed rhinoplasty for aesthetic corrections, but also for improvement of anatomical nasal airway obstruction.

Benefits of Closed Technique

Closed rhinoplasty or endonasal technique has many proponents among facial plastic surgeons, and many patients too prefer this procedure because of its relative simplicity and no external scarring. These proponents put forward the following benefits of closed rhinoplasty:

Reduced need for major surgical dissection

Reduced potential for loss of nasal tip support

Chances of post-surgical edema are decreased

Corresponding reduction in the potential for overall scarring to the nose apart from no external or visible scars

Potential to perform significant improvements in situ

A quicker and more predictable ability to feel the enhancements made to the nose

Potential to make targeted corrections without taking the nose apart

Reduced surgery time

Safer, particularly for older patients

Faster return to a normal appearance

Reduced overall recovery period and less discomfort during recovery

Patients should also note that if they are looking for substantive changes to the nose, they may require open rhinoplasty. It is paramount to have reasonable expectations from the closed technique.